| Statement of Deficiencies | (X1) Provider/Supplier/CLIA Identification Number 883842 | (X3) Date Survey Completed 05/11/2026 |
| Name of Provider or Supplier Dickson Medical Associate White Bluff | Street Address, City, State 2004 Highway 47 N, White Bluff, TN | |
| For information on the provider's plan to correct this deficiency, please contact the provider or the state survey agency. | ||
| (X4) ID Prefix Tag | Summary Statement of Deficiencies
(Each deficiency should be preceded by full regulatory or LSC identifying information) |
| J0000 | An unannounced on-site recertification survey was initiated at the facility on 05/11/2026 at 10:15 AM. An Entrance Conference was held at the facility with the facility Administrator on 05/11/2026 at 10:30 AM. The purpose and scope of the survey were explained. Requests were made and an opportunity for questions/concerns were provided. An Exit Conference was held at the facility with the facility Administrator on 05/11/2026 at 1:15 PM. Initial results of the recertification survey with citations of deficiencies were provided. |